Sample Record
Owner Lab
- Kie-Con, Incorporated - Antioch
DIME Sample ID 2021-04-15-10
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Project Information
| Project Identifiers | Project ID: 215236 DEA: 081C6804 EFIS: 0812000343 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-74,79and371-Varies |
| Award Date | 12/29/2020 |
| Closeout Date | Not set |
| Work Description | REPLACE STRUCTURAL CONCRETE BRIDGE, RETAINING WALL AND BOX CULVERT. |
| Location Description | RIVERSIDE COUNTY AT VARIOUS LOCATIONS |
| QA Service Level | 1 (Verified on 03/02/2021) |
Sample Information
| Sample Taken Date | 04/15/2021 | Sample Unique Key | 10 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 04/17/2021 |
| Sample type | Quality Control | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 29 CY | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Tim | Last name of sampler or witnessed by | Jellinghausen |
| Title of sampler | QC Inspector Technician | Telephone number of sampler | 9253317131 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | KIE-CON, INC | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | K5060-502 CPA |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 110002 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | 20-163B 4/15/21 | |
| A detailed description of where the material sample was collected | Concrete sample from wheelbarrow | Where the material sample would have been placed if not sampled | Voided Slab |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-04-15-10-1 ASTM C39-18 (Verified)
DIME Test ID: 2021-04-15-10-2 ASTM C39-18 (Verified)